An unusual presentation of cholecystoduodenal fistula: vomiting of gallstones. (19th November 2012)

• Record Type: Journal Article
• Authors: Thomson, Wendy L; Miranda, Sumeet; Reddy, Anil
• Is Part Of: BMJ case reports. Volume 2012
• Publication Date: 2012-11-19
• Subjects: Medicine -- Case studies -- Periodicals; 610.5
• DOI: 10.1136/bcr-2012-007009
• Languages: English
• ISSNs: 1757-790X

Abstract

Abstract : Bouveret's syndrome is defined as gastric outlet obstruction secondary to an impacted gallstone in the duodenum via a cholecystoduodenal or cholecystogastric fistula. Common radiological findings include pneumobilia, calcified right upper quadrant mass, pyloric or duodenal obstruction and cholecystoduodenal fistula. Initial attempts through endoscopic retrieval may be successful; however, results can vary. Surgical options include enterolithotomy or gastrotomy with or without cholecystectomy and fistula repair. We describe a unique case of Bouveret's syndrome with short-lived obstruction followed by vomiting of gallstones in a morbidly obese patient and discuss the complexities of investigation and management of these patients.